L. Buchanan, K. Khosrotehrani
We report an interesting and rare case of drug induced cutaneous lupus in a middle aged lady who was being treated for severe rheumatoid arthritis (RA) with tocilizumab (Actemera). She had had a remarkable response with previously refractory RA but after her 3rd dose of Actemera she developed a pruritic erythrosquamous eruption in photo distributed areas. Biopsies conﬁrmed drug induced-lupus like reaction. To our knowledge there has only been one report of drug induced lupus with Actemera,l to date. It is an interleukin-6 receptor antagonist that is used in patients who do not respond to the disease-modifying anti-rheumatic drugs. This became a management dilemma as the patient had not responded to many other treatments for her RA.